RESEARCH - Combined oral contraceptive use linked to risk for SLE

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Combined Oral Contraceptive Use Linked to Risk for Systemic Lupus Erythematosus

April 13, 2009 — Use of combined oral contraceptives (COCs) is linked

to increased risk for systemic lupus erythematosus (SLE), according to

the results of a population-based, nested case–control study reported

in the April 15 issue of Arthritis Care & Research.

" Endogenous hormonal factors are believed to play an important part in

the etiology of SLE, " write Marie-Odile Bernier, MD, MSc, from McGill

University in Montreal, Quebec, Canada, and colleagues. " Estrogen

contained in contraceptives has been also questioned.... However, the

role of exogenous estrogen as a trigger of SLE remains controversial

because studies of the link between exogenous hormonal exposure and

SLE risk have produced conflicting results. "

The study population consisted of women aged 18 to 45 years identified

from the United Kingdom's General Practice Research Database (GPRD).

From 1994 to 2004, there were 786 patients with SLE found in the

database and matched with up to 10 control individuals (n = 7817)

among women without SLE at the time of the diagnosis of the patient

with SLE.

The adjusted rate ratio (RR) of incident SLE associated with any use

of COC was 1.19 (95% confidence interval [CI], 0.98 – 1.45). For

current use of COC, adjusted RR was 1.54 (95% CI, 1.15 – 2.07).

Current users who had only recently started COC use had a higher RR

than did longer-term current users (RR, 2.52; 95% CI, 1.14 – 5.57 vs

RR, 1.45; 95% CI, 1.06 – 1.99). Current exposure to first- or

second-generation contraceptives was associated with especially

increased risk (RR, 1.65; 95% CI, 1.20 – 2.26). Risk increased further

with increasing dose of ethinyl estradiol (RR, 1.42, 1.63, and 2.92

for ≤30 µg, 31 – 49 µg, and 50 µg, respectively).

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Read the full article here:

http://www.medscape.com/viewarticle/591028

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